Peak Insurance Broker

Independent Insurance Agent/Broker

Health Insurance Specialist

Get Covered Under the Peak!

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Frequently Asked Questions (FAQ)

 

  • Life changes can make it so I can enroll outside of Open Season.  Why?
  • What life changes would allow me to qualify to enroll outside of Open Season?
  • What is going  on with Healthcare in Colorado?
  • Where do I sign up for the exchanges?
  • Under what conditions can I enroll?
  • What benefits do I get out of this?
  • How much is this going to cost me?
  • What is the Open Enrollment and when?

 

Please call me 719-434-2015, my name, is Jo Anne Bly, and I am happy to be your agent.

I will help you navigate the Connect for Health Colorado site and send you the official link.

 

What can I do for you as a Licensed Colorado Agent?

 

I shop for your health Insurance needs. I know the plans and the companies. If you apply on line please use my name Jo Anne Bly, as you’re Licensed Agent/Broker, as I can help you with the application and going forward. Let's admit healthcare coverage is complicated, I can explain it to you from an educated and informed point of view. Please call.

 

What are the Exchanges?

 

The exchanges have been designed to assist all Americans to obtain health insurance.

 

Who do you represent?

 

The companies I represent are: Anthem, Cigna, Humana, Rocky Mountain, Bright, and CO Choice

 

What is the official link is for Colorado?

 

You might ask, "Will I be able to purchase coverage through Connect for Health Colorado?"

 

The answer is, YES! Peak Insurance Broker can help you select what you need.

 

Please call me 719-434-2015, my name, is Jo Anne Bly, and I am happy to be your agent.

I will help you navigate the Connect for Health Colorado site.

 

Does the calculator on the Colorado Marketplace Website provide definitive estimates of what people will pay under the health reform law?

 

No. The calculator is intended to illustrate how families in varying circumstances may be affected by the tax credits and certain limits.

 

Premiums will vary from region to region and based on assumptions insurers make in setting premiums. In addition to what people would pay in premiums, they would also have out-of-pocket expenses for cost sharing (e.g., deductibles and coinsurance), which in some cases would be subsidized based on income. In addition, there are many other factors that could increase or decrease how much people pay, including efforts to make the health care system more efficient and additional revenue measures to finance the federal cost of reform.

 

How do premium subsidies work?

People purchasing coverage on their own will be eligible for government subsidies (through a tax credit) towards their health insurance premiums based on income. Subsidies will be provided to people with family income between 100% and 400% of the federal poverty level. The most that these families buying subsidized coverage in an exchange will pay towards a health insurance premium will range from 2.0% of income at 100% of poverty to 9.5% of income at 400% of poverty, with amounts at specific income levels specified in a table in the law. Subsidies are tied to a benchmark level of coverage based on actuarial value. And, subsidies will only be available to those purchasing coverage through the exchanges, which includes people who do not have access to alternative insurance (such as Medicaid and affordable employer coverage). When an exchange determines that a person is eligible for a tax credit based on expected income, and that person enrolls in coverage, subsidies will be  paid directly to insurers to lower the cost of premiums (and in some cases cost sharing).

 

For more information, please call me, Jo Anne Bly at 719-434-2015 or email me.

 

What is included in household income? How do I know what to enter for my income?

The calculator allows users to enter household income in terms of 2014 dollars or as a percent of the federal poverty level. Household income includes incomes of the taxpayer, spouse, and dependents. In determining eligibility for exchange subsidies, income will be based on your attestation of your expected income in 2017 and will be verified by the exchange with documentation from your most recent tax return, with consideration of reasonable changes you expect. Exchanges will calculate enrollees’ household incomes using Modified Adjusted Gross Income, or MAGI.  The MAGI calculation includes such income sources as wages, salary, foreign income, interest, dividends, and Social Security. MAGI calculation does not include income from gifts, inheritance, and Survivors Benefits, and some other income sources are partially excluded. More information on MAGI is available here.

 

 

What are Bronze and Silver plans?

When purchasing subsidized exchange coverage, you can choose between four levels of coverage: Bronze, Silver, Gold, and Platinum (in order of least to most comprehensive). In general, more comprehensive plans have higher premiums, but also have lower out-of-pocket costs. Bronze level coverage is the lowest level of coverage most people are required to have under health reform; on average bronze plans cover 60 percent of enrollees’ total costs. Silver level coverage is more comprehensive, covering on average 70 percent of enrollees’ total costs. The most comprehensive plans are Gold and Platinum plans, which on average cover 80 and 90 percent of enrollees’ total costs, respectively. For more information, see the question about actuarial value below.

 

 

What is a Special Enrollment Period?

A Special Enrollment Period is a period of time outside of the Open Enrollment Period during which an individual or household may shop for and enroll in private health insurance, or have their eligibility for financial assistance redetermined. Individuals may qualify for a Special Enrollment Period if they experience a Qualifying Life Change Event.

 

What is a Life Change Event?

A Life Change Event is an event that makes a customer eligible to make a change to their current health insurance plan outside of the annual Open Enrollment Period. The specific type of Life Change Event will determine whether you eligible to update your current plan, shop for a new plan, or enroll in coverage through Connect for Health Colorado for the first time. You must report any change to the Marketplace within 30 days of the event. If you are eligible to shop for a new plan, you will be given a special enrollment period. A Special Enrollment Period is a 60-day period, which starts from the date of your Life Change Event. If you qualify, the Special Enrollment Period may allow you to select and enroll in a new plan. In most cases, changes to your health plan will be effective the first day of the month after you select the plan. Examples of Life Change Events include, but are not limited to:

• Marriage or divorce.

• The birth or adoption of a child.

• Change of address (certain conditions apply).

 

Am I eligible for subsidies (financial assistance) to help pay for health insurance?

Individuals who apply for health insurance coverage through the Marketplace may be eligible for financial assistance to help pay for the health plan they select. Examples of financial assistance programs include: Medicaid, Advanced Premium Tax Credits, and Cost Sharing Reductions. In order to be eligible for financial assistance to help pay for health insurance, individuals must:

(1) Be eligible to purchase insurance through the Marketplace.

(2) Meet the income requirements based on their household size (email or call me for an estimate quote). Whether or not you are eligible for and/or enrolled in other coverage may also affect your eligibility for financial assistance. You can determine what financial assistance programs you and your family are eligible for by completing financial assistance application.

 

What income should I include on my application for financial assistance?

The income you report on your application is called your Modified Adjusted Gross Income (MAGI). In general, it is your estimated adjusted gross income (the income you report when you file your federal taxes) plus any tax-exempt Social Security, interest, or foreign income you estimate you will have for the year in which you are applying. Remember to report income changes of more than 10 percent to Connect for Health Colorado to avoid any penalties. If can’t estimate your income or you don’t want to fill out the financial assistance application, you have the option of buying health insurance without applying for financial assistance and, if eligible, claiming the lump sum of the tax credit when you file your federal taxes. Information about how to file taxes, including what incomes and allowances should be included, can be found at IRS.gov.

 

Where can I go for help understanding how the health reform law will affect me?

 

Call me Jo Anne Bly at 719-434-2015 or email me JoAnneBly@PeakInsuranceBroker.com.

Helping people understand Healthcare Insurance is what I do and I look forward to talking to you.

 

 

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